Healthcare Provider Details

I. General information

NPI: 1568426435
Provider Name (Legal Business Name): MEMORIAL HOSPITAL OF LARAMIE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/22/2024
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E 18TH ST
CHEYENNE WY
82001-5511
US

IV. Provider business mailing address

214 E 23RD ST
CHEYENNE WY
82001-3748
US

V. Phone/Fax

Practice location:
  • Phone: 307-633-7000
  • Fax:
Mailing address:
  • Phone: 307-634-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number07-218
License Number StateWY

VIII. Authorized Official

Name: MARGARET E. ALLEN
Title or Position: DIRECTOR OF BILLING SERVICES
Credential:
Phone: 307-773-8237